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Trauma Surgeons: Primary Care Practitioners by Default

Charles C. Wiles, MD
JAMA. 1993;269(19):2505-2506. doi:10.1001/jama.1993.03500190047024.
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To the Editor.  —The current national government has redirected the focus of the American health care system to primary care. Preventive care and first-contact patient care characterize the primary care medical specialties including family practice, general internal medicine, obstetrics/gynecology, general pediatrics, emergency medicine, and occupational medicine. Trauma surgery should be considered as a primary care specialty as well.The main cause of death and disability for people between the ages of 1 and 39 years is trauma. Nearly every citizen of the United States will be involved in a serious trauma event within his or her individual lifetime. The geriatric age group is the fastest growing segment of the trauma population and for many adolescents and young and middle-aged adults, trauma provokes their only interface with the health care system. Trauma is their index illness.Trauma is a disease of nights and weekends. Three quarters of patients present to trauma


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